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Changes in the Q-tip angle in relation to the patient position and bladder filling.

Yun JH, Kim JH, Park S, Lee C - BMC Urol (2015)

Bottom Line: It is hypothesized that patient position, supine or recline, and bladder filling status, empty or full, could change the Q-tip test result.The outcome of the Q-tip angle and the rate of UH changed in relation to patient position.The reclining position during bladder emptying increased the Q-tip angle, thereby resulting in a positive UH.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Gumi, South Korea. dulitle@daum.net.

ABSTRACT

Background: It is hypothesized that patient position, supine or recline, and bladder filling status, empty or full, could change the Q-tip test result. This study evaluated the effect of the patient position and bladder filling status on the Q-tip angle for urethral hypermobility (UH).

Methods: There was a measurement of the Q-tip angle in the supine position and at a 45° angle in a reclining position during bladder emptying; and then the measurements were repeated while filling the bladder. We defined urethral hypermobility as the urethral angle straining or coughing minus that at rest ≥ 30°.

Results: All 63 female patients (mean age: 61.6 years, range: 36-81) who complained of urinary incontinence were assessed using the Q-tip angle test. The pelvic organ prolapse quantification stages of all patients were ≤ stage 1. The mean Q-tip angle with an empty bladder was 14.1 ± 9.1° in the supine position and 16.4 ± 11.1° in the reclining position (p = 0.001). Then mean Q-tip angle during the filling bladder state was 15.4 ± 9.7° in the supine position and 15.9 ± 11.0° in the reclining position (p = 0.771). The UH rate during the bladder emptying state was 11.1 % (7/63) in the supine position and 19.1 % (12/63) in the reclining position. The UH rate during the bladder filling state was 15.0 % (9/60) in the supine position and 15.3 % (9/59) in the 45° reclining position. The odds ratio (OR) was 7.03 in the reclining position for a positive Q-tip angle. The positive rate was higher in the 45° reclining position during bladder emptying than that in the other position during bladder filling.

Conclusion: The outcome of the Q-tip angle and the rate of UH changed in relation to patient position. The reclining position during bladder emptying increased the Q-tip angle, thereby resulting in a positive UH.

No MeSH data available.


Related in: MedlinePlus

Comparison of the urethral hypermobility rate in relation to patient position. Positive urethral hypermobility was defined as a Q-tip angle ≥30°
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Fig1: Comparison of the urethral hypermobility rate in relation to patient position. Positive urethral hypermobility was defined as a Q-tip angle ≥30°

Mentions: The proportion of patients identified with UH during the bladder emptying state (Q-tip angle ≥30°) was 11.1 % (7/63) in the supine position and 19.1 % (12/63) in the reclining position. The proportion of patients with UH during the bladder filling state was 15.0 % (9/60) in the supine position and 15.3 % (9/59) in the reclining position. The reclining position had an odds ratio of 7.03 for a positive Q-tip angle (Table 2 and Fig. 1).Fig. 1


Changes in the Q-tip angle in relation to the patient position and bladder filling.

Yun JH, Kim JH, Park S, Lee C - BMC Urol (2015)

Comparison of the urethral hypermobility rate in relation to patient position. Positive urethral hypermobility was defined as a Q-tip angle ≥30°
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4597398&req=5

Fig1: Comparison of the urethral hypermobility rate in relation to patient position. Positive urethral hypermobility was defined as a Q-tip angle ≥30°
Mentions: The proportion of patients identified with UH during the bladder emptying state (Q-tip angle ≥30°) was 11.1 % (7/63) in the supine position and 19.1 % (12/63) in the reclining position. The proportion of patients with UH during the bladder filling state was 15.0 % (9/60) in the supine position and 15.3 % (9/59) in the reclining position. The reclining position had an odds ratio of 7.03 for a positive Q-tip angle (Table 2 and Fig. 1).Fig. 1

Bottom Line: It is hypothesized that patient position, supine or recline, and bladder filling status, empty or full, could change the Q-tip test result.The outcome of the Q-tip angle and the rate of UH changed in relation to patient position.The reclining position during bladder emptying increased the Q-tip angle, thereby resulting in a positive UH.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Gumi, South Korea. dulitle@daum.net.

ABSTRACT

Background: It is hypothesized that patient position, supine or recline, and bladder filling status, empty or full, could change the Q-tip test result. This study evaluated the effect of the patient position and bladder filling status on the Q-tip angle for urethral hypermobility (UH).

Methods: There was a measurement of the Q-tip angle in the supine position and at a 45° angle in a reclining position during bladder emptying; and then the measurements were repeated while filling the bladder. We defined urethral hypermobility as the urethral angle straining or coughing minus that at rest ≥ 30°.

Results: All 63 female patients (mean age: 61.6 years, range: 36-81) who complained of urinary incontinence were assessed using the Q-tip angle test. The pelvic organ prolapse quantification stages of all patients were ≤ stage 1. The mean Q-tip angle with an empty bladder was 14.1 ± 9.1° in the supine position and 16.4 ± 11.1° in the reclining position (p = 0.001). Then mean Q-tip angle during the filling bladder state was 15.4 ± 9.7° in the supine position and 15.9 ± 11.0° in the reclining position (p = 0.771). The UH rate during the bladder emptying state was 11.1 % (7/63) in the supine position and 19.1 % (12/63) in the reclining position. The UH rate during the bladder filling state was 15.0 % (9/60) in the supine position and 15.3 % (9/59) in the 45° reclining position. The odds ratio (OR) was 7.03 in the reclining position for a positive Q-tip angle. The positive rate was higher in the 45° reclining position during bladder emptying than that in the other position during bladder filling.

Conclusion: The outcome of the Q-tip angle and the rate of UH changed in relation to patient position. The reclining position during bladder emptying increased the Q-tip angle, thereby resulting in a positive UH.

No MeSH data available.


Related in: MedlinePlus